NHS is fire-fighting unstable disorders in Lancashire

A medical expert has warned nationwide underfunding is affecting both assessment and treatment for people in Lancashire with personality disorders.

Psychiatrist Dr Faheem Naqvi said mental health services are “fire-fighting” and warned it increased the risk of misdiagnoses.

Personality disorders are characterised by maladaptive behaviour causing distress from adolescence. People with these conditions can have an increased risk of suicide.

NHS figures show a total of 1,193 people were told they had emotionally unstable personality disorder (also known as borderline) in the county in the last three years. But there was only one diagnosis for each of the following personality disorders: schizoid, anankastic or anxious (avoidant).

Dr Naqvi, who formerly worked at Pendle House, Nelson, said: “People may not be getting the correct assessment and treatment due to nationwide stresses on both the NHS and the provision of specialist services for these conditions."

In Lancashire, 670 people aged 19 to 30 were given a personality disorder label in the last three years but the total was 148 for over 50s.

“Normally, if people are over 50 and being diagnosed for the first time, they may have had supportive relationships that kept them well,” said Dr Naqvi.

New broader criteria, called ICD-11, has been designed to make identifying these conditions simpler. Patients will be placed in the following groups: negative affectivity; disinhibition; detachment; dissociality; and anankastia. There will be more focus on the severity of symptoms and their effect on functioning.

In a national study, The University of Manchester discovered 154 people with personality disorders committed suicide in 2013. But only eight patients were seen by specialist services. DBT is designed to treat borderline personality disorder but 75% of patients did not receive it.

A Lancashire Care NHS Trust spokesman said: “We are presently working with an NHS health and care quality improvement organisation called Advancing Quality Alliance (AQuA) to make necessary improvements in our pathways and services while looking at some of the issues that our service users report.”